NPIMap

Individual provider Active NPI

Pedram Heidari, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1396184586
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
269073 Issued in MA
Practice address
55 Fruit St # 427
Boston, MA 02114-2621
Phone
(617) 724-4255
NPI assigned
Jun 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 269073 MA Primary

Addresses

Primary practice location

55 Fruit St # 427
Boston, MA 02114-2621

Mailing address

55 Fruit St
White 427
Boston, MA 02114-2621

Other practice location 1

115 Lincoln St
Framingham, MA 01702-6358
Phone (508) 383-1555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180516000716 MA Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 2769798305 Reassigns benefits to 4 organizations
I20230705003003 NH Practitioner - Diagnostic Radiology 2769798305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Boston, MA 02114-2215
Phone (617) 643-0003

18 Dover St
Cambridge, MA 02140-1206
Phone (617) 643-0003

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

67 Corporate Dr
Portsmouth, NH 03801-2847

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

789 Central Ave
Dover, NH 03820-2526
Phone (603) 742-5252

80 Everett Ave
Chelsea, MA 02150-2339
Phone (617) 887-3500

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 741-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cooley Dickinson Hospital Inc CurrentSince Mar 1, 2022 Accepting new patients
Cooley Dickinson Hospital Inc Current Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2018 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc CurrentSince Mar 1, 2022 Accepting new patients
General Hospital Corp Current Accepting new patients
Hampshire Pathologists, Inc. Current Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Past Accepting new patients

Locations

55 Fruit St
#427
Boston, MA 02114
Phone (617) 724-4255

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

12 College Hwy
Southampton, MA 01073
Phone (413) 527-1105

Interoperability endpoints

  • Direct secure messaging: heidari.pedram.mgh@direct.partners.masshiway.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396184586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "WHITE 427",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST # 427",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-4255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017026358",
            "country_code": "US",
            "telephone_number": "508-383-1555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIDARI",
        "first_name": "PEDRAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "269073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.